Estrella Yonathan, Bronzo Alexander, Fey Luke, Ryoo Aaron, Ayala Samuel, Lin Maya, Gaeta Theodore
Department of Emergency Medicine, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.
Department of Emergency Medicine, University of Miami, Miami, FL, USA.
Emerg Radiol. 2023 Apr;30(2):203-207. doi: 10.1007/s10140-023-02123-y. Epub 2023 Mar 14.
Point-of-care ultrasound (POCUS) has demonstrated excellent sensitivity and specificity for the diagnosis of DVT in the emergency department (ED). Before POCUS became widespread, patients underwent radiology department comprehensive lower extremity venous duplex ultrasounds (RADUS) which may be associated with a prolonged length of stay.
The goal of this study is to evaluate the impact of POCUS on ED arrival to disposition (ATD) time for patients presenting to the ED with suspected lower extremity DVT.
This is a retrospective chart analysis of ED visits to an urban, university-affiliated community hospital from January 2019 to December 2020. This study compared ATD between patients who underwent POCUS by an emergency medicine physician and RADUS by the radiology department.
In total, 1204 patients underwent POCUS, and 1582 patients were evaluated with RADUS. The POCUS mean ATD was 313 ± 16.8 min compared to the RADUS arm average of 323 ± 57.9 min (p = 0.56). Order to disposition time (OTD) was prolonged among the RADUS group relative to POCUS. ATD was significantly reduced in the POCUS subgroup of patients presenting during night shift when RADUS was not available, 326 ± 28.2 min versus 630 ± 109 min (p < 0.05).
ED POCUS scans decrease the amount of time between order placement and disposition when compared to RADUS. POCUS significantly decreases length of stay in the ED when RADUS is not available.
床旁超声（POCUS）在急诊科（ED）对深静脉血栓形成（DVT）的诊断中已显示出出色的敏感性和特异性。在POCUS广泛应用之前，患者需接受放射科的下肢静脉综合双功超声检查（RADUS），这可能会导致住院时间延长。
本研究的目的是评估POCUS对疑似下肢DVT的急诊患者从急诊就诊到出院（ATD）时间的影响。
这是一项对2019年1月至2020年12月期间一家城市大学附属医院急诊科就诊情况的回顾性图表分析。本研究比较了由急诊医学医生进行POCUS检查的患者与放射科进行RADUS检查的患者之间的ATD。
共有1204例患者接受了POCUS检查，1582例患者接受了RADUS评估。POCUS组的平均ATD为313±16.8分钟，而RADUS组的平均ATD为323±57.9分钟（p = 0.56）。与POCUS组相比，RADUS组的医嘱到出院时间（OTD）延长。在夜班期间无法进行RADUS检查时，POCUS亚组患者的ATD显著缩短，分别为326±28.2分钟和630±109分钟（p < 0.05）。
与RADUS相比，急诊POCUS扫描减少了从开单到出院的时间。当无法进行RADUS检查时，POCUS显著缩短了急诊住院时间。
